Individual provider Active NPI

Wendy R Mortimore, MD

  • Internal Medicine Physician
  • Madison, WI
National Provider Identifier
1841242674
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
47897 Issued in WI
Practice address
3102 Meriter Way
Madison, WI 53719-5833
Phone
(608) 417-8800
NPI assigned
May 17, 2006
Last updated
Jul 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 47897 WI
Internal Medicine Physician 207R00000X 47897 WI Primary

Addresses

Primary practice location

3102 Meriter Way
Madison, WI 53719-5833

Mailing address

202 S Park St
Madison, WI 53715-1507
Phone (608) 417-6000

Other identifiers 2

IdentifierTypeStateIssuer
039906262EOtherHUMANA
34637600MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wmortimore263528@direct.unitypoint.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090218000284 WI Practitioner - Internal MedicinePractitioner - Pediatric Medicine 4587605597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Medical College of Wisconsin, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meriter Hospital IncGroup PAC ID 3971412735, 122 clinicians

Practice addresses (Care Compare)

202 S Park St
Madison, WI 53715-1507
Phone (608) 417-6000

3102 Meriter Way
Madison, WI 53719-5833
Phone (608) 417-8800

7780 Elmwood Ave
Suite 201
Middleton, WI 53562-5407
Phone (608) 417-3434

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.59 of 100Reported as group
Quality
84.57
Promoting interoperability
91
Improvement activities
40
Cost
81.57

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke's Methodist Hospital Current Accepting new patients
Meriter Hospital, Inc. Current Accepting new patients
Meriter Hospital, Inc. CurrentSince Jan 1, 2016 Accepting new patients
Meriter Hospital, Inc. Past Accepting new patients

Locations

202 S Park St
Madison, WI 53715
Phone (608) 267-6000

3102 Meriter Way
Madison, WI 53719
Phone (608) 417-8800

Interoperability endpoints

  • Direct secure messaging: wmortimore263528@direct.unitypoint.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1841242674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 S PARK ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151507",
            "telephone_number": "608-417-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3102 MERITER WAY",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537195833",
            "telephone_number": "608-417-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTIMORE",
        "first_name": "WENDY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "47897",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "47897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "039906262E",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34637600",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wmortimore263528@direct.unitypoint.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3102 Meriter Way",
            "city": "Madison",
            "state": "WI",
            "country_code": "US",
            "postal_code": "537195833",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.